Characteristics of children with fever for 5 days or more with and without serious bacterial infection
| Non-SBI n=3459 (91.6%) | SBI n=319 (8.4%) | P value | ||
| General characteristics | ||||
| Age | Median (IQR) | 3.1 (1.6–6.1) | 2.4 (1.3–5.6) | 0.004 |
| Sex | Female, n (%) | 1545 (45) | 175 (55) | <0.001 |
| Previous visit to any healthcare provider in the last 7 days | n (%) | 1742 (54) | 187 (60) | 0.046 |
| Referral | n (%) | 1557 (46) | 202 (65) | <0.001 |
| Comorbidity | n (%) | 527 (15) | 56 (18) | 0.34 |
| Triage urgency classification | Emergent–very urgent | 217 (6%) | 24 (8%) | 0.12 |
| Urgent | 820 (24%) | 83 (26%) | ||
| Standard–non-urgent | 2340 (68%) | 187 (59%) | ||
| Duration of fever | Days, median (IQR) | 6 (5–7) | 6 (5–8) | <0.001 |
| Non-specific signs and symptoms | ||||
| Respiratory signs and symptoms | Any | 1458 (51%) | 102 (38%) | <0.001 |
| Gastrointestinal signs and symptoms | Any | 1024 (34%) | 109 (38%) | 0.18 |
| Other type of rash* | Any | 455 (15%) | 24 (8%) | 0.003 |
| Warning signs and symptoms | ||||
| Ill appearance | n (%) | 502 (17) | 97 (31) | <0.001 |
| Tachypnoea (breaths/min) | APLS thresholds, n (%) | 590 (31) | 54 (41) | 0.03 |
| Tachycardia (beats/min) | APLS thresholds, n (%) | 881 (32) | 112 (43) | <0.001 |
| Prolonged capillary refill | ≥3 s, n (%) | 43 (1) | 10 (4) | 0.006 |
| Oxygen saturations (%O2) | <94%O2, n (%) | 111 (4) | 15 (6) | 0.20 |
| Level of consciousness | Decreased (verbal, pain, unresponsive), n (%) | 10 (0) | 4 (1) | 0.03 |
| Increased work of breathing | n (%) | 410 (14) | 71 (27) | <0.001 |
| Non-blanching rash | n (%) | 84 (3) | 6 (2) | 0.61 |
| Neurological signs | n (%) | 21 (1) | 3 (1) | 0.64 |
| Seizures | n (%) | 33 (1) | 9 (3) | 0.003 |
| Diagnostics | ||||
| C-reactive protein | mg/L, median (IQR) | 18 (5–46) | 111 (71–174) | <0.001 |
| Laboratory testing at ED | Any, n (%) | 1946 (56) | 254 (80) | <0.001 |
| Imaging at ED | Any, n (%) | 900 (26) | 221 (69) | <0.001 |
| Treatment and outcomes | ||||
| Immediate life-saving interventions | Any, n (%) | 42 (1) | 8 (3) | 0.09 |
| Antibiotics prescribed this attendance | Any, n (%) | 1268 (37) | 292 (92) | <0.001 |
| Diagnosis—focus of infection | Upper respiratory tract | 1861 (54%) | 0 (0%) | <0.001 |
| Lower respiratory tract | 665 (19%) | 173 (54%) | ||
| Gastrointestinal | 172 (5%) | 19 (6%) | ||
| Urinary tract | 41 (1%) | 111 (35%) | ||
| Childhood exanthema | 221 (6%) | 0 (0%) | ||
| Soft tissue or musculoskeletal | 88 (3%) | 4 (1%) | ||
| Sepsis or meningitis | 10 (0%) | 12 (4%) | ||
| Undifferentiated fever | 247 (7%) | 0 (0%) | ||
| Inflammatory or other | 151 (1%) | 0 (0%) | ||
| Disposition | Discharge without follow-up | 1288 (37%) | 19 (6%) | <0.001 |
| Discharge with follow-up | 1302 (38%) | 108 (34%) | ||
| Admission <24 hours | 176 (5%) | 13 (4%) | ||
| Admission 24 hours or more | 614 (18%) | 173 (54%) | ||
| Admission, duration unknown | 41 (1%) | 4 (1%) | ||
| PICU | 16 (0%) | 2 (1%) | ||
| Left without being seen | 15 (0%) | 0 (0%) |
*This excludes any non-blanching rash including petechiae and purpura.
APLS, advanced paediatric life support; ED, emergency department; PICU, paediatric intensive care unit; SBI, serious bacterial infection.